Eugenics, long before transforming into mass killings under Nazism, was
conceived and applied as a tool of social management by the rulingclasses. Experimented with in asylums and hospitals, it became, with
Nazism, the laboratory for the Holocaust. But far from belonging solely
to the past, this logic of sorting "useful" and "useless" lives is
resurfacing today in health and old age policies. A feature article
proposed by CHLEE, an anti-ableist collective. ---- The process that led
to the genocide of European Jews, the massacre of Roma, homosexuals,
civilians, politicians, and the disabled did not appear overnight. An
ideology prefigured these horrors, emanating, among other things, from
19th-century ideas: eugenics[1].
The working classes of the industrial era worried the bourgeoisie and
the powers that be because of their revolutionary potential. Rural
migrations to urban and industrial centers, appalling living and hygiene
conditions, promiscuity, and the diseases that accompanied them
(syphilis, tuberculosis, etc.) led doctors to think about health from a
social and hygienic perspective in England, France, Germany,
Switzerland, and Sweden, as well as in Denmark and the United States.
Psychiatric illnesses, "asocial" behavior, alcoholism, vagrancy,
homosexuals, and Jews were seen as "burdens" on capitalist society. The
overall idea was to transform modern man into a being who met the
biological and racial criteria of the white man, devoid of physical or
psychological "defects."
Demonization of Disability
In Nazified Germany, the eugenic theories prevalent for a century in
Europe and the United States led to a policy of marginalization, then
the massacre of people with disabilities. Beginning in 1933, the Nazi
state apparatus launched a propaganda campaign to gain acceptance for
the euthanasia of people with disabilities by presenting them as an
economic and social burden. Posters, films, and school textbooks
depicted the "cost" of the sick and contrasted their maintenance with
the needs of a "healthy" society.
Films such as "Erbkrank" and "Ich Klage an," widely screened in
theaters, called for the elimination of lives deemed useless and
romanticized the euthanasia of the disabled. Asylum visits were
organized to portray the sick as "monsters" to be eliminated. Even
education participated in this propaganda, transforming mathematics into
a tool for justifying eugenics. Thus, in the primary school textbook,
one could find: "The construction of an insane asylum costs six million
marks. How many new homes costing 15,000 marks could be built with this
sum?"
This 1938 propaganda poster reads: "60,000 Reichsmarks is what the life
of this person suffering from a hereditary defect costs the working
class. Dear fellow citizens, this is also your money. Read the Neues
Volk, the monthly publication of the NSDAP's racial policy office."
German Historical Museum
The Beginning of a Massacre
In order to combat "inferior" elements, the Nazi regime promulgated the
so-called "Prevention of Hereditary Diseased Offspring" law on July 14,
1933, which imposed compulsory sterilization for the sick (psychiatric,
deaf, mute, etc.). It was implemented in early 1934, and 400,000 people
were sterilized, most of them forcibly[2].
As for the most disabled-those unfit for work-whose lives were deemed
"unworthy of living," special treatment was to be reserved for them. In
October 1939, Hitler signed a secret document, backdated to September 1,
authorizing the granting of a "Gnadentod" ("merciful death"). It stated:
"[Doctors]may grant a merciful death to patients who have been deemed
incurable according to the strictest possible assessment." The principle
was to eliminate sick Germans who tarnished the purity of the Aryan race.
Aktion T4: Holocaust Laboratory
A secret project reporting directly to the Führer's Chancellery, Aktion
T4, or Operation Euthanasia, was directed by Bouhler (a Nazi from the
very beginning) and Dr. Karl Brandt (Hitler's personal physician) from
the T4 Central Office (for Tiergartenstraße 4, "Zoo Street 4") in
Berlin. Alongside propaganda campaigns, this operation was tasked with
carrying out the extermination of physically and mentally disabled adults.
Forms were sent to treatment centers so that patients could be triaged
and transferred by the T4 Central Office to euthanasia centers. Killing
methods-gassing, food deprivation, injections-were tested on the
disabled and reused in the Holocaust. Of the 500 Nazis supervising
Aktion T4, 100 put their experiments into practice, eliminating Jews.
This operation was officially stopped in August 1941 after its discovery
by a section of the population and protests from the German clergy.
From the start of the war in 1939, hospitals were required to report
children suffering from hereditary pathologies; 6,000 were killed with
medication. It is difficult to estimate the number of people murdered,
particularly because of death certificates: the killings were disguised
as infectious diseases or deaths from natural causes. Until recently,
the number of deaths in Germany was estimated at over 70,000. Since the
opening of the East German archives, this number could be as high as
300,000 disabled people in Germany, Austria, Poland, and what is now the
Czech Republic.
In Germany, Hollerforden, a doctor specializing in brain research, used
697 brains from people killed as part of Aktion T4[3]. Nazi medical
experiments were also applied to disabled people, both living and dead.
As early as August 1941, some of the agents of Aktion T4 were redirected
to Aktion 14f13. During this killing campaign, which lasted from April
1941 to the end of 1944, thousands of inmates from the Buchenwald,
Dachau, Ravensbrück concentration camps were selected by doctors based
on medical criteria (the same forms as during Aktion T4). Patients,
Roma, vagrants, Jews, prostitutes, politicians, and antisocials were
gradually transferred to the T4 euthanasia program's extermination centers.
In 1944, patients were executed in extermination camps where they were
held and which had gas chambers or used specially adapted trucks. In
each asylum, a euthanasia policy was implemented for patients who were
"untreatable." They were killed by drug overdose, malnutrition, or
voluntary abandonment.
In France
Alexis Carrel, a collaborationist and innovative vascular surgeon who
worked and gained recognition in the United States (Nobel Prize in
1912), was the theoretician of eugenics in France. He published L'Homme,
cet inconnu in 1935, in which we read: "The establishment through
eugenics of a hereditary biological aristocracy would be an important
step towards solving the great problems of the present day" (Gallica p.
367). Carrel was able to disseminate his ideas in 1941 within the French
Foundation for the Study of Human Problems, which Pétain entrusted him
with the creation and direction of.
Pétainist France implemented a policy of systematic neglect towards the
most vulnerable. The dietary restrictions imposed by the government, the
lack of medical personnel, and Vichy's disinterest in people confined in
psychiatric institutions caused a true silent tragedy. Between 1940 and
1944, 45,000 psychiatric patients died of starvation due to deprivation
in French psychiatric hospitals. The cases of Camille Claudel and
Antonin Artaud are the most well-known. The elderly are not spared:
50,000 die of hunger in hospices, according to historian
Bueltzingsloewen[4].
This scale indicates the Rockwood clinical frailty score, often used in
geriatrics. The values of 8 (total dependence and approaching the end of
life) and 9 (terminal illness) are not shown.
Copyright-free
Relics of the past
The management of the COVID crisis today is reminiscent of the
reorganization operation (see timeline): the use of a "frailty score"
grid to decide who would have access to care led to a triage of
patients. Mediapart revealed an internal document from the Perpignan
hospital that addressed the issue of "triage" of patients, using the
term "acceptable" deaths for "very old or multi-pathological
patients"[5]. In April 2020, the High Council for Public Health adopted
the ideas of the French Society of Anesthesia and Resuscitation and
validated the use of the Rockwood frailty scale to legitimize the
refusal of care to certain categories of the population, including
people with disabilities.
Against a backdrop of declining access to care, France, like many
Western countries in recent years, is currently debating in Parliament a
bill aimed at legalizing euthanasia without naming it. Since disabled
people are included in the euthanasia eligibility criteria in this bill,
the social and medical context, the rise of the far right, and the
revival of eugenicist ideas should raise questions about the ideological
foundations truly underlying this bill[6]. The liberal press has already
defended euthanasia on the grounds that it would save money[7].
While representations of disabled people-particularly in cinema-present
their suicide as an altruistic act, and their living conditions continue
to deteriorate, disabled people are seen as a burden on society. Their
benefits are frozen, and they are increasingly monitored in the name of
fraud[8]. Once again, the frenzy of production and eugenics combine to
serve the interests of capital, disregarding so-called "unproductive" lives.
Collective for the Struggle and Disabilities for Equality and
Emancipation (CLHEE)
Chronology: The Application of Eugenics in Nazified Germany
July 14, 1933: Adoption of a law on "the prevention of hereditarily ill
offspring," known as the "sterilization law." August 18, 1939: Circular
from the Ministry of the Interior requiring maternity wards and
pediatric wards to report children under the age of three with
malformations or mental illness. August 31, 1939: End of the
sterilization program (approximately 400,000 people were sterilized,
most against their will). September 21, 1939: Circular from the Ministry
of the Interior ordered a census of all institutions treating "mentally
ill, epileptic, and mentally deficient persons." October 1939, Hitler
signed a secret document, backdated to September 1, 1939, authorizing
the granting of a "merciful death" to patients deemed incurable. From
1943 to 1945, the Nazi regime launched what it called "Aktion Brandt,"
or Operation Reorganization. Under the pretext of freeing up beds to
treat wounded civilians and soldiers, hospitals were "relieved" by
sacrificing the chronically ill, the elderly, and the disabled.
Validate
[1]For more details on eugenics, see our article from last month,
"Eugenics: Genealogy of a Far-Right Obsession," Alternative libertaire
No. 362, July-August 2025,
https://www.unioncommunistelibertaire.org/?Eugenisme-Genealogie-d-une-obsession-de-l-extreme-droite.
[2]Benoît Massin, "From Eugenics to the Holocaust," Study Circle on
Deportation and the Holocaust, December 16, 2008.
https://www.cercleshoah.org/spip.php?article31&lang=fr
[3]Berstein Catherine, T4: A Doctor Under Nazism, 2014, documentary
available on YouTube.
[4]Isabelle von Bueltzingsloewen, "Deaths from Starvation": Famine and
Exclusion in France under the Occupation, Presses universitaires de
Rennes, pp. 149-161, 2005.
[5]"Intensive care units prepare to triage patients to be saved,"
Mediapart, March 20, 2020.
https://www.mediapart.fr/journal/france/200320/les-services-de-reanimation-se-preparent-trier-les-patients-sauver
[6]"We are not 'collateral damage'," CLHEE, September 26, 2023.
https://clhee.org/2023/09/26/nous-ne-sommes-pas-des-dommages-collateraux
[7]Jérôme Cordelier, "Euthanasia would save 1.4 billion euros per year",
Le Point, February 8, 2025.
https://www.lepoint.fr/postillon/l-euthanasie-permettrait-d-economiser-1-4-milliard-d-euros-par-an-08-02-2025-2581832_3961.php.
Pierre-Henri de Menthon, "What if assisted suicide was good for the
Social Security accounts? ", Challenges, February 3, 2025.
https://www.challenges.fr/economie/et-si-le-suicide-assiste-faisait-du-bien-aux-comptes-de-la-securite-sociale_597669
[8]"Bayrou plans to reduce aid for the elderly and disabled,"
L'Essentiel de l'éco, August 22, 2025,
https://lessentieldeleco.fr/3117-bayrou-envisage-de-reduire-les-aides-aux-personnes-agees-et-handicapees.
https://www.unioncommunistelibertaire.org/?Aktion-T4-Quand-la-barbarie-capitaliste-triait-les-vies
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